Doxorubicin, also known as Adriamycin®, is a chemotherapy drug used to treat many different types of cancer.
It is best to read this information with our general information about chemotherapy and the type of cancer you have.
Doxorubicin is usually given into a vein. It can also be given into the bladder to treat bladder cancer. You usually have it as an outpatient or during a hospital stay. Your cancer doctor, nurse or pharmacist will tell you how often you will have it.
Like all chemotherapy drugs, doxorubicin can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.
Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:
Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.
Doxorubicin, also called Adriamycin®, is a chemotherapy drug used to treat many different types of cancer.
It is best to read this information with our general information about chemotherapy and the type of cancer you have.
Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.
This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.
This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.
You will have doxorubicin in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you. Doxorubicin can be given in combination with other drugs. During treatment you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information.
Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you about how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse will give you anti-sickness drugs before you start. Doxorubicin is then given in one of the following ways:
You have doxorubicin (a red fluid) as an injection directly into your cannula or line. You will have fluid through a drip (infusion) at the same time, to flush it through. Or you may have doxorubicin as a drip over a set time, using a pump.
Sometimes, it is given over a few days through a small pump, which is connected to your line. The pump can be carried on a belt or in a bag.
Doxorubicin can also be given straight into the bladder (intravesically) to treat non-invasive bladder cancer. When it is given this way, it rarely affects the rest of the body as only a very small amount of the drug is absorbed into the blood. You can read more in our information on non-invasive bladder cancer.
This is a short animation about how you can have a central line (or skin-tunnelled venous catheter) put in.
This is a short animation about how you can have a central line (or skin-tunnelled venous catheter) put in.
We explain the most common side effects of this treatment here. We also include some less common side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them.
If you are also having treatment with other cancer drugs, you may have some side effects that we haven’t listed here.
Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects.
It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you.
Your nurse will give you advice about managing your side effects.
After your treatment is over, most side effects start to improve.
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night.
Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Some people might have side effects while they are having the chemotherapy:
Some people have an allergic reaction while having this treatment. Signs of a reaction can include:
Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, it can be treated quickly.
Sometimes a reaction can happen a few hours after treatment. If you get any signs or feel unwell after you get home, contact the hospital straight away.
If this happens, it can damage the tissue around the vein. This is called extravasation. Extravasation is not common, but if it happens it is important that it is dealt with quickly. Tell your nurse straight away if you have any stinging, pain, redness or swelling around the vein.
If you get any of these symptoms after you get home, contact the doctor or nurse straight away. You should use the number they gave you.
You may suddenly feel warm and your face may get red while the drug is being given. This should only last a few minutes.
This treatment can reduce the number of white blood cells in your blood. These cells fight infection.
If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.
If you have an infection, it is important to treat it as soon as possible.
Contact the hospital straight away on the 24-hour contact number you have if:
Symptoms of an infection include:
It is important to follow any specific advice your cancer treatment team gives you.
The number of white blood cells will usually return to normal before your next treatment.
You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot.
Tell your doctor if you have any bruising or bleeding that you cannot explain.
This includes:
Some people may need a drip to give them extra platelets. This is called a platelet transfusion.
This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body.
If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.
You may feel sick in the first few days after this treatment. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you.
It is easier to prevent sickness than to treat it after it has started.
If you feel sick, take small sips of fluids and eat small amounts often.
If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.
Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished.
Try to pace yourself and plan your day so you have time to rest.
Gentle exercise, like short walks, can give you more energy.
If you feel sleepy, do not drive or operate machinery.
You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection.
Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.
If your mouth is sore:
This treatment can affect your appetite. Do not worry if you do not eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.
Your urine may be a pink-red colour for up to 48 hours after you have had your treatment. This is due to the colour of the drug.
If you have diarrhoea, contact the hospital for advice. Try to drink at least 2 litres (3½ pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.
Your hair will get thinner or you may lose all the hair from your head. You may also lose your eyelashes, eyebrows or other body hair. Hair loss usually starts after your first or second treatment.
Scalp cooling is a way of lowering the temperature of your scalp to help reduce hair loss. Your nurse can tell you if this is an option for you.
Your nurse can talk to you about ways to cope with hair loss. There are ways to cover up hair loss if you want to. It is important to cover your head to protect your scalp when you are out in the sun.
Hair loss is almost always temporary and your hair will usually grow back after treatment ends.
Chemotherapy may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. During treatment and for several months afterwards, you'll be more sensitive to the sun and your skin may burn more easily than usual. You can still go out in the sun, but use a suncream with a sun protection factor (SPF) of at least 30, and cover up with clothing and a hat.
Your skin may darken. It will return to its normal colour after you finish treatment. If you’ve had radiotherapy (either recently or in the past), the area that was treated may become red or sore.
Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Your nails may grow more slowly or break more easily. You may notice white lines across your nails, or other changes to their shape or colour. Once the treatment has ended, any changes usually take a few months to grow out.
There are things you can do to look after your nails:
This treatment can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your kidneys and liver are working.
This treatment may cause the cancer or leukaemia cells to break down quickly. This releases uric acid (a waste product) into the blood. The kidneys usually get rid of uric acid but may not be able cope with large amounts. Too much uric acid can cause swelling and pain in the joints, which is called gout.
Your doctor may give you tablets called allopurinol (Zyloric®) to help prevent this. Drinking at least 2 litres of fluid a day will also help. You will have regular blood tests to check the uric acid levels.
Your eyes may become watery and feel sore. Your doctor can prescribe eye drops to help with this. If your eyes get red and inflamed (conjunctivitis), tell your doctor. This is because you may need antibiotic eye drops.
Denton describes how he coped with fatigue (tiredness) during his treatment for prostate cancer.
Denton describes how he coped with fatigue (tiredness) during his treatment for prostate cancer.
In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.
In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.
This treatment can affect the way the heart works. You may have tests to see how well your heart is working. These may be done before, during and sometimes after treatment.
If the treatment is causing heart problems, your doctor can change the type of treatment you are having.
Contact a doctor straight away if you:
Other conditions can cause these symptoms, but it is important to get them checked by a doctor.
Doxorubicin can increase the risk of developing a second cancer, years later. This is rare. If a second cancer develops it is usually leukaemia. But the benefits of treatment usually far outweigh this risk. Your doctor can talk to you about this.
Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:
If you have any of these symptoms, contact a doctor straight away.
A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can affect chemotherapy or be harmful when you are having it. This includes medicines you can buy in a shop or chemist.
Tell your cancer doctor about any drugs you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Some cancer drugs can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.
Chemotherapy can sometimes stop the ovaries working. You may not get a period every month and they may eventually stop. In some women, this is temporary, but for others it is permanent and they start the menopause.
If you have sex in the first few days after chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluids.
Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.
Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment.
Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.
Robert talks about having treatment to preserve his fertility when he was diagnosed with Hodgkin lymphoma.
Robert talks about having treatment to preserve his fertility when he was diagnosed with Hodgkin lymphoma.
If you have a lot on your mind, you might find it useful to make a checklist. You can use our checklists for home, work and travel to help you get organised.
Order booklets or audio CDs about chemotherapy. It includes how it works, having treatment and how it might affect you.
All types of treatment can have different side effects. Know what to expect to help you find the best way for you to handle them.
What's happening near you? Find out about support groups, where to get information and how to get involved with Macmillan where you are.
Read about our Community champions' experience of chemotherapy. They talk about what to bring to treatment, side effects and friendship between patients.
A support group for everything about chemotherapy, being treated and side effects. Tell others about your experiences and get answers to your questions.
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